NPI | 1134189459 |
---|---|
Former Name | SHIRL ROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: NY 010347-1) |
Additional Taxonomies | 103T00000X Psychologist (Licence: NY 010347) |
Enumeration Date | 2006-03-23 |
Last Update Date | 2023-01-27 |